聚乳酸防粘连凝胶及透明质酸钠预防术后肠粘连效果的对比分析_徐伟全

2013年5月第51卷第14期

·药物与临床·

CHINA MODERN DOCTOR 中国现代医生腹腔术后肠粘连一直是困扰外科医生的一个棘手难题。文献报道[1]，腹部外科手术后约90％有粘连。目前，临床上常在术毕前涂沫抗粘连药物以预防肠粘连，常见的抗粘连药物有聚乳酸防粘连凝胶和透明质酸钠。因此，在腹部手术结束关腹前分别使用这些药物以预防肠粘连，观察术后恢复情况和肠粘连表现，以比较两者的预防效果，为临床应用提供参考。

1资料与方法1.1临床资料

选择2005年1月～2011年9月我院收治的需行腹部

手术的病例856例，根据患者选择抗粘连药物的不同分为聚乳酸防粘连凝胶组427例和透明质酸钠组429例，分别采用聚乳酸防粘连凝胶和透明质酸钠进行术后的预防用药。入组病例的一般资料情况见表1，两组患者的病例数、性别比例、平均年龄及手术方式差异均无统计学意义（P >

0.05），具有可比性。1.2方法

两组患者手术结束后关腹前，在止血充分的前提下，使用无菌生理盐水冲洗腹腔以拭尽腹腔内残留血液及积液，将6~12mL 无菌医用聚乳酸防粘连凝胶或透明质酸钠均匀涂布于手术创面、腹腔、盆腔肠管受损的部位及切口

聚乳酸防粘连凝胶及透明质酸钠预防术后肠粘连

效果的对比分析

徐伟全

广州市白云区第一人民医院普外科，广东广州

510410

[摘要]目的对比观察聚乳酸防粘连凝胶和透明质酸钠在预防腹部术后肠粘连的临床疗效，以指导临床用药。

方法根据患者选择抗粘连药物的不同，将患者分为聚乳酸防粘连凝胶组和透明质酸钠组，手术结束关腹前，分别涂以聚乳酸防粘连凝胶或透明质酸钠，观察术后患者体温恢复正常所需时间、肠管通气时间以及术后6个月肠粘连的表现。结果所有患者中，术后均未出现药物过敏现象，并且无不适症状，无脓肿、肠瘘及其他不良反应，术后改善情况良好。观察术后1周患者的各项恢复情况如发热时间、肠鸣音恢复时间、肛门排气时间，聚乳酸防粘连凝胶组显著优于透明质酸钠组，差异有统计学意义（P ＜0.05）。聚乳酸防粘连凝胶组在术后3个月和术后

6个月发生肠粘连表现的患者例数显著少于透明质酸钠组，差异有统计学意义（P ＜0.05）。结论聚乳酸防粘连

凝胶和透明质酸钠对腹部手术后预防肠粘连均有明显作用，聚乳酸防粘连凝胶预防粘连效果优于透明质酸钠。

[关键词]肠粘连；聚乳酸防粘连凝胶；透明质酸钠；预防[中图分类号]R619[文献标识码]B [文章编号]1673-9701（2013）14-0071-02

The effects of polylactic acid gelcombined with sodium hyaluronate in the prevention of postoperative ankylenteron

XU Weiquan

Department of General Surgery,the First People ’s Hospital of Baiyun District of Guangzhou City in Guangdong Province,Guangzhou 510410,China

[Abstract]Objective To compare the effects of polylactic acid gel with sodium hyaluronate in the prevention of post -operative ankylenteron,to explore the clinical strategy.Methods According to the selection of patients with anti adhe -sion drug is different,the patients were randomly divided into polylactic acid gel group and sodium hyaluronate group,completed in operation before closing abdomen,are coated with polylactic acid gel or hyaluronic acid sodium,observa -tion of postoperative patients with restoration of normal temperature time required,intestine ventilation time and after 6months of intestinal adhesion performance.Results In all patients,postoperative were found drug allergies,and no dis -comfort symptoms,without abscess,fistula and other adverse reactions,postoperative improvement in good condition.Observation of postoperative 1weeks in patients with various recovery:such as the heating time,borborygmus recovery time,anal exhaust time,poly lactic acid anti -adhesion gel group was significantly better than that of sodium hyaluronate group,the difference was statistically significant （P ＜0.05）.Poly lactic acid anti-adhesion gel group in 3months after operation and postoperative 6months of intestinal adhesion performance of the number of patients was significantly less than the sodium hyaluronate group,the difference was statistically significant （P ＜0.05）.Conclu -sion Poly lactic acid gel and sodium hyaluronate on preventing postoperative intestinal adhesions have obvious effects,polylactic acid anti-adhesion gel adhesion prevention effect is better than that of sodium hyaluronate.[Key words]Postoperative ankylenteron;Polylactic acid gel;Sodium hyaluronate;Prevention

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